ORDER FORM
Please send us this order form when you found the car you want to buy, after fill out this order form specifically.
Please push
"SEND"
button after completed this form accordingly.
*
*
*
required (
*
)
1
Your name
*
2
Company name
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3
You are ......
Please select
Car importer
Car dealer
Private importer (Re-sell bases)
Individual person (Personal use)
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4
Address
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5
State
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6
Country
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7
e-mail
* no space at left side
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8
e-mail again (confirm)
* no space at left side
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9
Tel number
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10
Fax number
*
11
URL
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12
Mobilephone number
*
*
*
*
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13
STOCK CAR No.
*
*
14
Port of destination
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15
Shipping terms
Please select
FOB Japan
CIF destination
C&F destination
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16
Currency
Please select
US dollars
Japanese yen
*
17
Message (If you have)
*
Copyright ( C ) /2006 All right Reserved
Fullhouse International Limited operates with Permission from Gunma Public Safety Commission.
Reg. No. 421110199800